DR. CALIXTO JOSE CORNAVACA DIAZ M.D.
NPI 1326381625
General Practice in Buford, GA

NPI Status: Active since April 04, 2013

Contact Information

578 S ENOTA DR NE
STE C
BUFORD, GA
ZIP 30519
Phone: (423) 619-8381
Fax: (470) 290-8474

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  • Individual
  • Male
  • Years of Experience 21
  • General Practice
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About CALIXTO CORNAVACA DIAZ

This page provides the complete NPI Profile along with additional information for Calixto Cornavaca Diaz, a primary care provider established in Buford, Georgia with a medical specialization in General Practice and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1326381625 assigned on April 2013. The practitioner's primary taxonomy code is 208D00000X with license number 74951 (GA). The provider is registered as an individual and his NPI record was last updated 7 years ago.

NPI
1326381625
Provider Name
DR. CALIXTO JOSE CORNAVACA DIAZ M.D.
Gender
Male
Entity Type
Individual
Location Address
578 S ENOTA DR NE STE C BUFORD, GA 30519
Location Phone
(423) 619-8381
Location Fax
(470) 290-8474
Mailing Address
578 S ENOTA DR NE STE C GAINESVILLE, GA 30501
Mailing Phone
(470) 892-6607
Mailing Fax
(470) 290-8474
Medical School Name
OTHER
Graduation Year
2006
Is Sole Proprietor?
No
Enumeration Date
04-04-2013
Last Update Date
03-15-2019
Code Navigator

A primary care provider (PCP) like Calixto Cornavaca Diaz sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Secondary Locations

  • 3615 Rolling Creek Dr
    Buford, GA 30519
    (423) 619-8381

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

General Practice

Taxonomy Code
208D00000X
Type
Allopathic & Osteopathic Physicians
License No.
74951
License State
GA
Taxonomy Description
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
  • SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
  • SoloCare Gold EPO $1500 DED 10010 - EPO
  • SoloCare Silver EPO $5000 DED 10014 - EPO
  • SoloCare Silver EPO $6500 DED 10013 - EPO
  • SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
  • SoloCare Standard Gold EPO $2000 DED 10006 - EPO
  • SoloCare Standard Platinum EPO $0 DED 10005 - EPO
  • SoloCare Standard Silver EPO $6000 DED 10007 - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Calixto Cornavaca Diaz is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Calixto Cornavaca Diaz is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7517100803

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20181120000668

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Advance care planning, first 30 minutes

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

This service was performed 24 times for 24 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

This service was performed 115 times for 26 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 49 times for 24 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 35 times for 22 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

This service was performed 97 times for 22 patients

Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preve

Prolonged preventive service refers to an extended medical consultation or treatment beyond the usual time. This service, provided in an outpatient setting, involves direct patient contact for the first 30 minutes beyond the primary procedure. It's used when additional time is required to address preventive health needs.

This service was performed 15 times for 15 patients

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

This service was performed 112 times for 26 patients

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1326381625, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
2
Doubled → 4
Pos 4
6
Unchanged
Pos 5
3
Doubled → 6
Pos 6
8
Unchanged
Pos 7
1
Doubled → 2
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 3 → 6 1 → 2 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 4 + 6 + 6 + 8 + 2 + 6 + 4 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1326381625.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1326381625, enumerated as an "individual" on April 04, 2013.

The provider is located at 578 S ENOTA DR NE STE C BUFORD, GA 30519 and the phone number is (423) 619-8381.

General Practice with taxonomy code 208D00000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc.. Please consult your insurance carrier or call the provider to verify.